DA Form 5412 Waiver of Compensation Statement

DA Form 5412 Waiver of Compensation Statement

What Is DA Form 5412?

This is a military form that was released by the U.S. Department of the Army (DA) on April 1, 2019. The form, often mistakenly referred to as the DD Form 5412, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.

FAQ

Q: What is DA Form 5412?
A: DA Form 5412 is a form used for Waiver of Compensation Statement.

Q: What is the purpose of DA Form 5412?
A: The purpose of DA Form 5412 is to document an individual's waiver of compensation.

Q: Who uses DA Form 5412?
A: DA Form 5412 is used by the United States Army.

Q: When is DA Form 5412 used?
A: DA Form 5412 is used when an individual voluntarily waives their right to compensation.

Q: What information is included in DA Form 5412?
A: DA Form 5412 includes information about the individual waiving compensation, the period of time the waiver is effective, and any additional remarks or conditions.

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Form Details:

  • A 1-page document available for download in PDF;
  • The latest version available from the Army Publishing Directorate;
  • Editable, free, and easy to use;
  • Fill out the form in our online filing application.

Download an up-to-date fillable DA Form 5412 down below in PDF format or browse hundreds of other DA Forms stored in our online database.

Download DA Form 5412 Waiver of Compensation Statement

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  • DA Form 5412 Waiver of Compensation Statement, Page 1
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